Application Forms

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0><table border="0" cellpadding="0" cellspacing="0" width="100%"><tr><td> <p> </p> </td></tr></table><table dir="ltr" border="0" cellpadding="0" cellspacing="0" width="100%"><tr><td valign="top"><table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=82 BGCOLOR="#006699" TEXT="#080000"> <div> <FONT SIZE="2" COLOR="#FFFFFF" FACE="Arial" ><B>About Us</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="About Us"><U><B>home</B></U></A></div> <div> <A HREF="id33.htm" TARGET="_top" TITLE="FAQ"><U>FAQ</U></A>   |   <A HREF="id34.htm" TARGET="_top" TITLE="Winter/Spring/Summer 06 Calendar of Even"><U>Winter/Spring/Summer 06 Calendar of Events</U></A>   |   <A HREF="id35.htm" TARGET="_top" TITLE="Kamp Kessa Intensive Challenge Learning "><U>Kamp Kessa Intensive Challenge Learning Camp Experiences</U></A>   |   <A HREF="id52.htm" TARGET="_top" TITLE="Curriculum"><U>Curriculum</U></A>   |   <A HREF="id41.htm" TARGET="_top" TITLE="Kamp Kessa Staff"><U>Kamp Kessa Staff</U></A>   |   <A HREF="id42.htm" TARGET="_top" TITLE="Travis and Jake Loring Scholarship Fund"><U>Travis and Jake Loring Scholarship Fund</U></A>   |   <A HREF="id43.htm" TARGET="_top" TITLE="Testimonials"><U>Testimonials</U></A>   |   <A HREF="id50.htm" TARGET="_top" TITLE="Needs and Wishes"><U>Needs and Wishes</U></A>   |   <B>Application Forms</B>   |   <A HREF="id61.htm" TARGET="_top" TITLE="TTouch Workshop Opportunity"><U>T-Touch Workshop Opportunity</U></A>   |   <A HREF="id327.htm" TARGET="_top" TITLE="Bits from Beth"><U>Bits from Beth</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000"> <div> <IMG SRC="0adc8920.jpg" border=0 width="200" height="146" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">At Kamp Kessa </div> <div> Introductions are Formal</div> </td> <td valign="top" height=398 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <B> <a href="Parent%20intro/Parent_Intro_letter.doc"><u>Parent_Intro_letter.doc</u> </a>  </B><A HREF="file://M:\kk survey" TARGET="_top" TITLE="file://M:\kk survey"><U><B> <a href="HTMLobj-170/Kamp_Kessa_Activity_permission.doc"><u>Kamp_Kessa pre & post survey</u> </a>  </B></U></a><B> <a href="HTMLobj-170/Kamp_Kessa_Activity_permission.doc"><u>Kamp_Kessa pre & post survey</u> </a>  </B><A HREF="file://C:\My Documents\KK Forms\Participants application packet.doc" TARGET="_top" TITLE="file://C:\My Documents\KK Forms\Particip"><U><B> <a href="HTMLobj-305/Participants_application_packet.doc"><u>Participants_application_packet.doc</u> </a>  </B></U></a><B> <a href="HTMLobj-305/Participants_application_packet.doc"><u>Participants_application_packet.doc</u> </a>  </B><A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><B>hWhat to bring to Kamp Kessa</B></U></A></div> <DIV ALIGN="LEFT"></DIV> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U>Spring/Summer  list</U></A></div> <bR> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Sleeping bag and pillow (you may want extra blankets!)</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Flashlight and set of extra batteries</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Backpack (small) (optional)/fanny pack for horse ride if available</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Sweats, sweatshirt and modest nightwear</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">3 or 4 pairs of jeans </U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Plenty of socks and underwear for daily changes and emergencies</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Rain jacket or poncho</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Flipflops or slip on shoes for night and showers</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Tennis shoes for hiking and smooth soled boots or shoes with a heel or cowboy boots if available.</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Personal items for shower if you have preference (Kamp has soap, shampoo, and conditioner)  Bring your own toothbrush & toothpaste please.</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">All necessary medication plainly marked in original bottles</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Copy of your medical insurance card</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Canteen or water bottle</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Safety approved riding helmet if available</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Any items you don't have, please ask for assistance, go to second hand stores, etc.  No child is refused because of not having adequate equipment.</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><IMG BORDER="0" SRC="Wing0a730071011800000000.png" HEIGHT="19" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Properly fitting Helmet for riding if you have it.</U></A></div> <bR> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U>Directions:</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U>Take exit 43 (395Waddy/Peytona) off of highway 64 (between Shelbyville and Frankfort Kentucky) Take 395 North for around 4 miles.  Take a Right on 1779.  Go 3.2 miles. You will see a Sheltered Risks Inc, Kamp Kessa sign (just after the 9 mile marker)as the road turns sharply to the left.  Go right on the access road and take the first drive to the left.  Go down to the pole barn to check in.</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U>See you at Kamp Kessa</U></A>.  Call for check in time 502-376-4367 </div> <bR> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U>Do not bring any electronic equipment, gameboys, radios, headphones, etc.  This is a wilderness setting.  Thank you.</U></A></div> <div> <A HREF="file://M:\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://M:\Kamp Kessa Forms\What to bring"><U><B>at to bring to Kamp Kessa.doc</B></U></A><B>e</B><A HREF="file://C:\My Documents\Kamp Kessa Forms\What to bring to Kamp Kessa.doc" TARGET="_top" TITLE="file://C:\My Documents\Kamp Kessa Forms\"><U><B>file://C:\My Documents\Kamp Kessa Forms\What to bring to Kamp Kessa.doc</B></U></A><B>ltered Risks Incorporated</B></div> <div> Please apply on line or send completed applications to:</div> <bR> <div> Sheltered Risks Incorporated          c/o Anthony Howard</div> <div> 758 Beechridge Rd.</div> <div> <I>Frankfort, KY 40601</I></div> <bR> <div> <B>Tuition for open enrollment camp is $700 per week</B>. --See Sliding fee scale link for private pay.  Agency rates available for multiple referrals.</div> <bR> <div> <A HREF="file://C:\My Documents\KK Forms\ScholarshipSliding Fee Scale for Private Pay06.doc" TARGET="_top" TITLE="file://C:\My Documents\KK Forms\Scholars"><U> <a href="HTMLobj-306/ScholarshipSliding_Fee_Scale_for_Private_Pay.doc"><u>Sliding Fee Scale Scholarship for private pay</u> </a>  </U></a><U> <a href="HTMLobj-306/ScholarshipSliding_Fee_Scale_for_Private_Pay.doc"><u>Sliding Fee Scale Scholarship for private pay</u> </a>  </U></div> <bR> <div> To be given priority consideration, please enclose a $100 nonrefundable down payment made out to `Sheltered Risks Incorporated' with your completed application.  Some scholarships and sliding fee rate available. Call 502-376-4367 for special consideration.</div> <div> Full payment of tuition is due by the first day of camp (unless other arrangements for payment have been made).</div> </td> </tr></table> </td></tr></table></body>